SALEM — In a preview of what is likely a month-long political slam-dance, the House narrowly passed the first of a string of contentious tax bills Thursday by a single vote.

The House voted 36-23 to approve HB 2391, a health provider tax supporters say will generate $550 million to pay for the medical care for the state’s low-income residents. The bill increases taxes on hospitals and imposes a new levy on insurance premiums.

As with all tax bills, it required a three-fifths vote to pass. Democrats are one vote short in both the House and Senate.

On Thursday, the margin was provided by a yes vote from Rep. Sal Esquivel, R-Medford, a six-term House member who has announced he will not run for re-election in 2018.

The bill now goes to the Senate.

The GOP Senate caucus is smaller, making discipline on some issues tighter. That reality led Senate President Peter Courtney, D-Salem, to publicly despair about the chances to get the Democratic agenda through to Gov. Kate Brown’s desk.

The health provider tax bill was the opening salvo in a battle over how to close a $1.4 billion budget deficit. Democrats want Republicans to support more taxes and fees before agreeing to cut programs, while Republicans want the cuts first before they consider ways to raise more money.

The Democrats have pressed ahead with their agenda, hunting for the necessary Republican vote willing to cross over. The fight over priorities, plus the sheer heft and complexity of the legislation, has led to a backlog of bills.

House Speaker Tina Kotek, D-Portland, has called for morning and afternoon sessions to make up ground and broke with the months-long pattern of not holding floor sessions on Fridays by scheduling one this week.

Kotek had originally scheduled a vote on the health provider bill and companion pieces of legislation for Friday. But after apparently lining up a Republican vote that would push the bill through, Kotek switched the vote to the afternoon session.

Rep. Dan Rayfield, D-Corvallis, introduced the bill and said it was a consensus effort involving both parties, as well as health care businesses and consumer advocates. While the Oregon Health Authority has had severe management and technology problems, crippling the agency was not an answer.

“Within OHA, there is a $900 million shortfall,” Rayfield said. “We need to ensure more than a million Oregonians will keep their health care.”

Under the bill, large hospitals will pay a 6 percent tax, while small hospitals will pay 4 percent. Insurance companies will pay 1.5 percent on all premiums, which will be used to stabilize subsidies for low-income residents.

The efforts of President Trump and his Republican allies in Congress to “repeal and replace” the Affordable Care Act, known as Obamacare, threatens to remove assistance given to low-income Americans to pay for their health insurance premium.

Legislation that passed through the U.S. House Energy and Commerce Committee, chaired by Rep. Greg Walden, R-Hood River, would remove the subsidies.

During the debate Thursday in Salem, Republicans attacked portions of the bill they said would hurt children, college students, small employers and others.

Critics said those groups would be forced to make up for money lost under the Cover Oregon debacle and its glitch-prone successors at the Oregon Health Authority.

“It intends to do the right thing, but misses the mark,” said Rep. Julie Parrish, R-Tualatin.

Rep. Knute Buehler, R-Bend, who is an orthopedic surgeon, said he wanted to ensure everyone in Oregon had access to quality health care.

But he opposed the bill as giving legislative approval to the Oregon Health Authority’s flawed handling of the program.

“We have had success with the Affordable Care Act in Oregon,” said Buehler, adding, “the exchange continues to struggle. We are going to see nearly a 60 percent increase in premiums in the next few years. Now we are adding taxes?”

Buehler suggested the Legislature fund the program for one year instead of two and come back during the short session of the Legislature in 2018 with a longer-term fix.

Rayfield then re-capped the talking points of the bill, Kotek said “call the role” and the bills squeaked through. That left Courtney and Senate Democrats to search for the one vote needed to get it out of the Legislature, onto the governor’s desk and into law.